Refractoriness in tsetse flies (Diptera: Glossinidae) may be a matter of timing

Tsetse flies (Diptera: Glossinidae: Glossina spp.) are vectors for African trypanosomiasis, a devastating disease that kills both people and animals in sub-Saharan Africa. Trypanosomes ingested with an infected bloodmeal reside within the gut of tsetse and eventually move to the salivary glands where they become transmissible during blood feeding. Although tsetses are efficient vectors for disease transmission, infection prevalence in the field is surprisingly low, a trait referred to as refractoriness. Refractoriness is relatively more pronounced in palpalis subgroup flies, although certain species within the susceptible morsitans species complex are also highly refractory, such as Glossina pallidipes Austen. We examined the role of the humoral immune response in refractoriness to infection by comparing the expression of the antimicrobial peptide gene attacin across three species with varied vector competence. Gene expression was measured both temporally (time after feeding and fly age) and spatially (tissue specificity). Although microbial immune challenge induces attacin expression in all three species, "refractory" fly species showed an uninduced, baseline level of systemic (fat body) attacin, whereas the "susceptible" flies did not. In addition, refractory species had a higher level of attacin expression in the proventriculus and midgut. We also found that blood feeding alone up-regulated attacin expression in refractory species but not in the susceptible species. Finally, reverse genetics showed that repression of attacin by double-stranded RNA-mediated RNA interference increased susceptibility to trypanosome infection in G. pallidipes. The role of early, uninduced attacin expression, and its role in relative refractoriness in tsetse, is discussed.     

A new approach to alar rim defects: mucocartilaginous turnover flap

The main principle of reconstructive surgery is replacement of the defective tissues with like tissues. A full-thickness defect of the nasal ala should be reconstructed in three layers: innermost mucosal layer, outermost skin, and the cartilage in-between. The aim of this study is to describe a technique for single-stage, three-layer reconstruction of the full-thickness ala nasi defects. This technique was used on three patients with tumors involving the nasal ala. Resulting full-thickness defects are reconstructed with a mucocartilaginous turnover flap planned from the contralateral side. Aesthetically acceptable results are obtained without the compromise of the nasal airway and with minimal donor site morbidity. None of the patients requested a revision operation. In conclusion, this is a novel technique with minimal donor site morbidity and good postoperative results. Moreover, lost tissues are replaced with exactly the same kind of tissues.     

Relationship between left ventricle geometric patterns and lymphocyte DNA damage in patients with untreated essential hypertension

OBJECTIVE: To investigate the association between different the left ventricle (LV) geometric patterns and lymphocyte DNA damage in patients with hypertension (HT). METHODS: We studied 84 patients (50.0+/-6.1, years) with HT and 24 healthy control subjects (48.6+/-3.3, years). Four different geometric patterns were identified in patients according to LV mass index and relative wall thickness. Peripheral lymphocyte DNA damages and plasma levels of total antioxidant status (TAS) were determined in all subjects. RESULTS: DNA damage was increased in hypertensive patients compared with control group (p=0.001). The major increase in DNA damage was observed in concentric hypertrophic geometric pattern compared with all other geometric patterns (p<0.001, for all). In multiple linear regression analysis, lymphocyte DNA damage was independently correlated with only TAS (beta=-0.444, p<0.001), but not LV geometry (p>0.05). CONCLUSION: The major increase in lymphocyte DNA damage was observed in concentric hypertrophic geometric pattern. This result may be related to increased oxidative stress.     

Investigation of serum vitamin D and ischaemia-modified albumin levels in infertile Turkish men

Our aim was to explore the existence of a possible relationship of sperm motility with serum 25-hydroxyvitamin D3 (25-OH VD) levels and with ischaemia-modified albumin ( IMA) levels in infertile Turkish men. A total of 30 men with nonobstructive azoospermia (no spermatozoa in ejaculate), 30 men with oligospermia (total progressive motile sperm count (TPMSC) <15 × 10⁶/ml) and 33 fertile men with normospermia (with at least one child, as the control group) were enrolled in the study. The mean 25-OH VD levels for groups 1, 2 and 3 were 9.31 ± 6.46, 19.71 ± 12.80 and 30.52 ± 12.49 respectively (p < .05). There was a statistically significant difference in serum IMA levels among the groups (479.32 ± 307.56 vs. 296.37 ± 127.27 vs. 150.04 ± 81.05, respectively; p < .05). A positive correlation between serum 25-OH VD levels and TPMSC, and a negative correlation between TPMSC and serum IMA levels were determined. Infertile men had lower serum 25-OH VD and higher IMA levels than fertile men, with a positive correlation between serum 25-OH VD levels and TPMSC, and a negative correlation between TPMSC and serum IMA levels. Vitamin D supplementation may increase the sperm motility.     

Surgery for Hepatolithiasis: Single Center Experience of 12 Patients

Hellenic Journal of Surgery - Hepatolithiasis is the presence of stones within the intrahepatic bile ducts, regardless of common bile duct and gallbladder stones. It is rarely seen in our country...     

Treatment outcome of relapse and defaulter pulmonary tuberculosis patients.

SETTING: Tuberculosis clinic in a referral hospital. OBJECTIVE: To evaluate the effect of risk factors on the outcome of retreatment in relapse and defaulter pulmonary tuberculosis patients. DESIGN: A total of 57 retreatment tuberculosis patients treated and monitored in our centre between January 1997 and June 1999 were evaluated with respect to treatment outcome. Factors which have on effect on treatment outcome were investigated. RESULTS: Of 57 patients, 37 (64.9%) were classified as relapse cases and 20 (35.1%) as defaulters. The treatment success rate was 71.9% (68.4% cure rate and 3.5% completion rate). Failure was encountered in 22.8%. Twenty-six patients (45.6%) exhibited resistance to at least one drug, namely rifampicin. The multidrug-resistance (MDR) rate was 18.5%. Treatment success rates were 100% and 50%, respectively, in patients in whom susceptibility to all drugs and resistance to at least one drug were detected. Successful outcome was possible in 68.8% of patients with any rifampicin resistance and in 20% of patients with MDR tuberculosis. Retreatment resulted in failure in 80% and 100%, respectively, of patients whose sputum cultures remained positive at the end of the second and third months. CONCLUSION: Drug resistance proved the most important factor affecting treatment outcome. Success rates in retreatment of patients with any rifampicin resistance or MDR tuberculosis are low. Conversion to negative sputum results at the end of the second and third months of retreatment seems to be a significant parameter for a successful outcome.     

Superior vena cava thrombosis in chronic lead exposure--a case report

Thrombosis is a rare cause of superior vena cava syndrome (SVCS). A 43-year-old male patient with SVCS due to thrombosis underwent investigation for the etiology of thrombus formation. He had been hospitalized several times because of lead intoxication in the past. Lead has a known thrombogenetic effect experimentally. This patient with superior vena cava thrombosis had thrombophilia that was probably due to lead intoxication. The etiologies of venous thrombosis and thrombogenetic effect of chronic lead exposure are discussed.